Food Allergy Action Month: Food Allergy vs. Food Intolerance Top 8 Allergens: Healthy Eating Tip of the Month May 2018
What is a food allergy? What is food intolerance? Food allergy: The immune system overreacts to a food that is typically harmless. It creates an allergic antibody (IgE) to try to get the food out of the body. IgE can be made by the body even if the food has been eaten frequently in the past (but this is unusual). Food intolerance: The immune system is not involved in the response and there is a problem digesting the food. The response is not as dangerous as an allergic reaction.
Symptoms of food allergy: happen rapidly-within 2 hours or less Mild to moderate Hives (reddish, swollen, itchy areas on the skin) Eczema flare (a persistent dry, itchy rash) Redness of the skin, particularly around the mouth or eyes Itchy mouth or ear canal Nausea or vomiting Diarrhea Stomach pain Nasal congestion or a runny nose Sneezing Slight, dry cough Odd taste in mouth Severe: swelling of lips, tongue, & throat blocks breathing Trouble swallowing Shortness of breath or wheezing Turning blue Drop in blood pressure (feeling faint, confused, weak, passing out) Loss of consciousness Chest pain A weak pulse Sense of impending doom
Symptoms of food intolerance: Can take up to 72 hours to see Bloating Migraines Headaches Cough Runny nose Feeling under the weather Stomach ache Irritable bowel Hives Common Food Intolerances: Lactose, a natural sugar found in milk, cheese, and other dairy products Sulfites, found in wines, pickled foods, and sodas Gluten, a protein in wheat, barley, rye, and some other grains Caffeine, in coffee, tea, soda, energy drinks Salicylates, natural chemicals that are produced by plants as a defense against environmental stressors like insects and disease; found in fruits, vegetables, teas, coffee, spices, nuts and honey Fructose, a natural sugar found in most fruits and also in high-fructose corn syrup FODMAPs (fermentable oligosaccharides disaccharides monosaccharides and polyols), these are carbohydrates that draw water into your intestine during digestion. They cause gas, bloating, and abdominal pain. Others include: MSG, yeast, eggs, food colorings, and sugar alcohols
Example: Milk Allergy vs. Lactose Intolerance A milk allergy is when the immune system reacts to a protein contained in milk and initiates an immune response. http://ib.bioninja.com.au/standard-level/topic-2-molecular-biology/ 25-enzymes/lactose-intolerance.html Lactose intolerance is the lack (or low level) of the enzyme lactase in the gut, which is needed to break down the sugar lactose, found in milk. When lactose is consumed, it passes through the intestine undigested, is fermented by bacteria, and causes unpleasant symptoms, which are discussed below. https://www.dogonews.com/2014/10/16/say-goodbye-to-peanut-allergies/page/5
How to read a food label for milk allergens Read product labels every time you purchase an item as ingredients may change without notification. Food manufacturers are required to label foods that contain any of the top 8 food allergens (milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soy). Note: Manufacturers are not required by law to label allergens in non-food items (cosmetics, medications). Look in the ingredients list Or listed separately
Milk Allergy Avoid foods that contain milk or any of these ingredients: Butter, butter fat, butter oil, butter acid, butter ester(s) Buttermilk Casein Casein hydrolysate Caseinates (in all forms) Cheese Cottage cheese Cream Curds Custard Diacetyl Ghee Half-and-half Lactalbumin, lactalbumin phosphate Lactoferrin Lactose Lactulose Milk (in all forms including condensed, derivative, dry, evaporated, goat s milk and milk from other animals, low-fat, malted, milkfat, non-fat, powder, protein, skimmed, solids, whole) Milk protein hydrolysate Pudding Recaldent (R) Rennet casein Sour cream, sour cream solids Sour milk solids Tagatose Whey (in all forms) Whey protein hydrolysate Yogurt
Milk Allergy Other Possible Sources of Milk- avoid these if your allergy is severe: Artificial butter flavor Baked goods Caramel candies Chocolate Lactic acid starter culture and other bacterial cultures Luncheon meat, hot dogs and sausages, which may use the milk protein casein as a binder. Also, deli meat slicers are often used for both meat and cheese products, leading to cross contamination. Margarine Non-dairy products, as many contain casein Nougat Shellfish is sometimes dipped in milk to reduce the fishy odor. Ask questions when buying shellfish. Tuna fish, as some brands contain casein Some specialty products made with milk substitutes (i.e., soy-, nut- or rice-based dairy products) are manufactured on equipment shared with milk. Many restaurants put butter on grilled steaks to add extra flavor. You can t see the butter after it melts. Some medications contain milk protein. Allergens are not always present in these food and products, but milk protein can appear in surprising places. Again, read food labels and ask questions if you re ever unsure about an item s ingredients.
Lactose Intolerance What causes lactose intolerance? Some people are born with little or no enzyme lactase in their gut. In fact, lactose intolerance affects 15-75 % of all adults depending on race, food habits and gut health (1). Other causes are certain digestive diseases, such as Crohn's disease, ulcerative colitis, celiac sprue (an inherited disorder affecting the lining of the small intestine), inflammatory bowel diseases, and injuries to the small intestine (surgery or trauma) may reduce the amount of lactase available to process lactose properly. If the small intestine is injured, lactose intolerance may only be temporary and can go away after the intestine has healed. Avoid these products: -Whey -Caseinates -Nougat -Most cheeses (avoid soft cheeses) -Milk by-products -Casein -Dry milk solids -Lactose -Curds -Nonfat dry milk -Dry milk powder Also avoid items that state "may contain milk" on the food label. Depending on the severity of your symptoms, you may need to avoid or limit foods containing these ingredients. People with lactose intolerance can eat the following products because they contain little to no lactose: aged hard cheeses (cheddar, Swiss, parmesan), yogurt (with live active cultures), butter, kefir, and goat s milk.
Dairy-Free Alternatives Processed foods Cream cheese: Daiya, Kite Hill, Tofutti, Go Veggie Shredded cheese: Daiya, Lisanatti, So Delicious, Follow Your Heart Cheese slices: Daiya, Field Roast, Go Veggie Yogurt: Kite Hill, Almond Dream, Silk Cheese blocks: Lisanatti, Daiya, Follow Your Heart Ice cream: Ben and Jerry s, So Delicious, Almond Dream, Halo Top, Silk Nut milks: Rice Dream, Blue Diamond, So Delicious, Silk, Ripple Others Some recipe substitutions use nutritional yeast for cheesy sauces and as a substitute for parmesan cheese. Raw cashews that are soaked in water for a few hours, drained, and ground into a paste can substitute for cheese to make creamy sauces for pasta or vegetables.
Importance of Calcium in a Dairy-free/Dairyrestricted diet Calcium is needed for proper nerve function, muscle contraction, and healthy bones and teeth. In a dairy-free/restricted diet it is important to consider alternative sources of calcium, like plants. Table 1. Recommended Dietary Allowance of calcium by age group Age Group Recommended Dietary Allowance (mg/day) 1 3 years 700 mg 4 8 years 1,000 mg 9 18 years 1,300 mg 19 50 years 1,000 mg 51 70 years, males 1,000 mg 51 70 years, females 1,200 mg 70+ years 1,200 mg 14 18 years, pregnant/breastfeeding 1,300 mg 19 50 years, pregnant/breastfeeding 1,000 mg Source: Adapted from Dietary Reference Intakes for Calcium and Vitamin D, Institute of Medicine, National Academy of Sciences, November 2010.
Here are some plant-based/alternative sources of calcium to help you get the recommended calcium! Food Serving size Amount of calcium Broccoli 1 cup chopped 43 mg Kale 1 cup chopped 101 mg Arugula 1 cup 125 mg Garbanzo beans ½ cup 105 mg White beans ½ cup 100 mg Black beans ½ cup` 147 mg Chia seeds 1 tablespoon 80 mg Blackstrap molasses 1 tablespoon 172 mg Dried figs 2 figs 55 mg Orange 1 medium fruit 65 mg Almonds 1 ounce 75 mg Almond butter 2 tablespoons 56 mg Oatmeal ¾ cup 20 mg Wheat bread 1 slice 20 mg Tofu ½ cup 434 mg Herring 3 ounces 48 mg Soy milk 8 ounces 450 mg Almond milk 8 ounces 450 mg For an example meal plan, you could have a smoothie with soy/almond milk and kale and toast with almond butter for breakfast, a salad with arugula and beans for lunch with a few figs and an orange, and tofu and stir-fry veggies for dinner and you would get about 1400 mg of calcium- over the recommended amount of 1000 mg!
References: 1. Food Allergy Research & Education. Symptoms of an Allergic Reaction to Food. Accessed March 10, 2018 at: https://www.foodallergy.org/life-with-foodallergies/food-allergy-101/symptoms-of-an-allergic-reaction-to-food 2. Food Allergy Research & Education. Milk Allergy. Accessed March 10, 2018 at: https://www.foodallergy.org/common-allergens/milk 3. McGill University. (2018). "Nutritionally-speaking, soy milk is best plantbased milk: Closest to cow's milk in range of nutrients it offers." ScienceDaily. Accessed March 10, 2018 at: www.sciencedaily.com/releases/2018/01/180129131311.htm. 4. National Institutes of Health. Lactose Intolerance. Accessed March 7, 2018 at: https://www.niddk.nih.gov/health-information/digestive-diseases/lactoseintolerance 5. Ross, A. Catharine et al. (2011). The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know. The Journal of Clinical Endocrinology and Metabolism 96.1: 53 58. PMC. Web. Accessed March 10, 2018. 6. U.S. Food and Drug Administration. (2006). Food allergen labeling and consumer protection act of 2004 (FALCPA). Accessed March 10, 2018 at: https://www.fda.gov/food/guidanceregulation/guidancedocumentsregulato ryinformation/allergens/ucm106890.htm Rachel Bessire, MPH 300 N. Ingalls Street NIB NI8E20 Ann Arbor, MI 48109-5407 http://www.med.umich.edu/pfans/services/tip.html For more information on allergies please visit https://medicine.umich.edu/dept/foodallergy/education-resources/foodallergy-resources